Organization
PEDIATRIC & ADOLESCENT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTINA LANE PADILLA (ADMINISTRATIVE ASSISTANT)
(859) 977-3044
Entity
Organization
Contact information
Practice address
171 N EAGLE CREEK DR, LEXINGTON, KY 40509-1801
(859) 977-3044
(859) 977-0237
Mailing address
3050 HARRODSBURG RD, LEXINGTON, KY 40503-2747
(859) 977-3044
(859) 977-0237
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65911612
—
KY
Enumeration date
04/12/2007
Last updated
08/22/2020
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